Background: Despite the strong commitment at both national and international levels to eradicate hunger and achieve household food security, by 2030 food insecurity remains a public health problem. South Africa is amongst the countries with the highest rate of income inequality in the world and extremely high levels of absolute poverty. The Gini coefficient in South Africa is estimated at 0.68 Although South Africa may be food secure at a national level, large numbers of households within the country are food insecure approximately 52% of the rural households in Limpopo Province of South Africa were considered severely food insecure. It has been noted that the majority of households in South African informal settlements and rural areas were moderately or severely food insecure due to lack of access to food which was directly related to income. Rural areas have assets that can be explored to support households. The adult population above 18 years in South Africa make up 78% of the 5.9 million population with about 40% living in rural areas, this study explored household food insecurity in adults in rural environments. The current study aimed to explore the socioeconomic and dietary determinants of household food insecurity among the adult population in the Limpopo Province. Methods: A cross-sectional survey design was used, and data were collected using a validated pre-tested questionnaire. The participants were recruited from households in Limpopo province. Multiple linear regression was computed to explore the influence of socioeconomic and dietary practices on food insecurity. Results: The study included 699 randomly selected participants of which the majority earned a monthly income ≤ 3000 ZAR, and 31.8% experiencing hunger in the past 30 days at the time of study. The dietary practices of the participants were found to be associated with household food insecurity. The study found that large family size, being female in South Africa, low household income and low rate of regular breakfast intake were significant determinants of household food insecurity (p < 0.05). Conclusion: In summary, most of the households were poor and approximately one-third were food insecure. The implementation of sustainable employment policies, and food-based approaches and targeting rural household food production could significantly reduce food insecurity in the rural area.

Food insecurity, obesity and hypertension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 participants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of participants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79–5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hypertension 32.3%. Being a woman, older and married significantly positively influenced obesity and hypertension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hypertension status of participants (p<0.05). Food insecurity, obesity and hypertension rates remain high among adults in the Limpopo Province of South Africa with consumption of a diet low in dietary variety. Aged and married women were more likely to be obese and hypertensive, while daily fruit and vegetable intake were found to be a protective factor. Educational and nutritional intervention should be designed and geared towards promoting fruit and vegetable intake in the community.Significance: Households had a diet low in dietary variety, with dietary diversity revealed as a determinant of health risk. Dietary diversity is inversely correlated with household food security. The findings also identified household determinants of obesity and hypertension, which are major public health issues in South Africa.

The aim of this study was to determine knowledge and practices of pre-school teachers on growth monitoring. A quasi-experimental, one-group pre- and post-test intervention study was conducted in eight conveniently selected government subsidized pre-schools in Vhembe and Mopani districts of Limpopo Province, South Africa. Fifteen pre-school teachers participated in the study. An intervention in a form of nutrition education lessons on growth monitoring was developed and implemented. Pre-school teachers completed a knowledge test questionnaire prior to the lessons. The intervention also included the following training skills: procedure to take anthropometric measurements and plotting the Road to Health Chart. About 67% teachers understood the importance of growth monitoring at baseline. The results also showed an improvement 6 months after intervention. All (100%) teachers knew that growth monitoring can be used for diagnosing undernutrition. The results also showed an improvement in skills, such as the procedure to take anthropometric measurements. Knowledge and practices of teachers on growth monitoring were improved by nutrition education 6 months after intervention.

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk.

Background: Child growth monitoring and promotion give caregivers the knowledge and tools they need to track their children’s growth. The Road-to-Health Booklet (RtHB) is used to record the child’s health and development during clinic visits. Aim: The aim of this study is to explore caregivers’ use of the RtHB in selected villages within Thulamela Municipality. Setting: The study was conducted in selected villages within Thulamela Municipality. Methods: A qualitative descriptive exploratory study was conducted using a semi-structured interview guide to gain insights into caregivers’ experiences with the RtHB. Purposive sampling was used to select 28 caregivers of children under 5 years of age for this research. In-depth interviews were conducted to gather comprehensive data, which were recorded through field notes and an audio recorder. Thematic content analysis was employed to analyse the collected data. Results: Findings revealed that caregivers perceive the RtHB as a critical tool provided after delivery for maintaining records of their children’s health status, growth and immunisation history. Some caregivers indicated that some of the information should be excluded from the Booklet because they believe information such as HIV status is confidential. Conclusion: In Thulamela municipality, caregivers demonstrated a clear understanding of the RtHB, including its purpose, appropriate usage and benefits. However, some expressed concern about the inclusion of HIV status in the Booklet. There is a need for the Department of Health to come up with strategies to keep confidential information such as HIV status through the use of code on the Booklet. Contribution: The results may contribute to the body of literature related to the caregivers’ use of the RtHB.